Risk Factors For Developing Clots
Any pregnant woman is at increased risk for developing a blood clot. However, some women have additional factors that put them at increased risk. Factors specific to pregnancy include diabetes, preeclampsia, or a having a C-section delivery. Prolonged bedrest, say for preterm labor or premature rupture of the membranes, also will add additional risk.
Other general conditions that increase a pregnant womans risk include age over 35, being obese, and being a smoker. Women who have a known genetic predisposition for developing clots are at highest risk during pregnancy.
Pregnant Don’t Overlook Blood Clots
Pregnant or recently delivered a baby? Dont overlook blood clots.
Although anyone can develop a blood clot, women are at higher risk for a blood clot during pregnancy, childbirth, and up to 3-months after delivering a baby. In fact, pregnant women are 5 times more likely to experience a blood clot compared with women who are not pregnant. Dont let a blood clot spoil your joy during this exciting time! Learn about pregnancy-related blood clots and tips on protecting yourself and your baby for a safe and healthy pregnancy.
What is a blood clot?
A blood clot in the deep vein is a medical condition that typically occurs in the lower leg, thigh, pelvis or arm. When a DVT is left untreated, a part of the clot can break off and travel to the lungs, causing a blockage called a pulmonary embolism . A PE can stop blood from reaching the lungs and can be deadly. Although blood clots are preventable, a PE is one of the most common causes of pregnancy-related death in the United States.
Why are pregnant women at higher risk for a blood clot?
Blood clots are preventable: Learn how to protect yourself and your baby
- Know your risk for a blood clot. Pregnancy is one factor that can put women at higher risk for developing a blood clot, but other factors can increase your risk for a blood clot, including:
- A family or personal history of blood clots or a blood clotting disorder
- Delivery by C-section
A Word About Antibiotics
So many patients call asking for antibiotics for a cold,usually when theyve had symptoms for several days. There are a few times whenantibiotics are appropriate, for instance, strep throat or sinus infectionscaused by bacteria. But antibiotics simply dont work against viruses thatcause the common cold. Overprescribing antibiotics for viral illnesses leads toantibiotic resistance, which means the bacteria grow stronger over time andbecome tougher to beat with antibiotics.If a doctor prescribes an antibiotic for cold symptoms, its usually a short,three-day round of drugs. The patient often feels better after finishing themedication but probably would have recovered in that timeframe anyway withoutthe drug.
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Variations In Risk Factors
A report by Philipp et al indicated that risk factors for thrombosis in women who have had adverse pregnancy outcomes differ significantly between white and black women. In the study, involving 409 patients who had adverse outcomes in pregnancy, the investigators determined the following:
The prevalence of protein S and antithrombin deficiencies were more prevalent in black patients
Diagnosed thrombophilia was more prevalent in white women
The frequency of a family history of thrombophilia, VTE, and stroke or MI was greater in white patients
The body mass index was higher in black women
Hypertension was more prevalent in black women
The investigators, however, also found no significant difference between white and black patients with regard to personal history of VTE. The prevalence of sickle cell disease among black women in the study was about 27-fold higher than that in the overall black population of the United States.
After Your Baby Is Born
After your baby is born, you will need to take heparin for at least 6 weeks.
You may need to take it for longer if the DVT or PE was diagnosed late in your pregnancy. It is safe to breastfeed while taking heparin.
Some women may be asked to take a blood thinning tablet instead of having heparin injections. You may also be referred to a haematologist. This is a doctor who specialises in blood clot disorders.
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Anticoagulation In Pregnant Patients With Valvular Heart Disease
Warfarin is more efficacious than unfractionated heparin for thromboembolic prophylaxis of pregnant women with mechanical valves. Unfortunately, warfarin therapy in the first trimester of pregnancy is associated with a substantial increase in fetal anomalies, and anticoagulation with any agent is associated with an increased incidence of fetal wastage , prematurity , and low birth weight .
Blood Thinners During Pregnancy And Breastfeeding
Generic Name: LMW HeparinsFDA Drug Category: BSummary Recommendations: LMW blood thinners like Heparin are prescribed for the treatment of blood clotting disorders in women with a history of blood clots and to prevent other pregnancy complications. LMW heparins do not cross the placenta and are considered a safe alternative to traditional heparin during pregnancy. Names for common LMW heparins include enoxaparin, Fragmin and dalteparin.
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Videostaying Active And Healthy With Blood Thinners
People often worry about how routine medicines like blood thinner pills will affect their lifestyles. With a few simple steps, taking a blood thinner can be safe and easy. In fact, more than 2 million people take blood thinners every day to keep them from developing dangerous blood clots. Staying Active and Healthy with Blood Thinners is a 10-minute video that shows how small changes in daily routines can help people take blood thinners safely.
What is a blood thinner? What does it do? Why it is helpful? These questions are answered in this video, which features easy-to-understand explanations of how blood thinners work and why it’s important to take them correctly. It also introduces BEST, an easy way to remember how to fit blood thinner medication into daily life.
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Is There Anything Else I Can Do
It is important that the heparin injections are monitored when you are pregnant so your blood thinning is at the right level. This will make sure your blood is not too thin which can cause bleeding or not thin enough which can cause blood clots. It is also important to maintain a healthy weight during pregnancy and to exercise a little this reduces the risk of blood clots developing.
Prevent Pregnancy Blood Clots
By virtue of being pregnant or in the postpartum period, expectant women and new moms are at an increased risk of DVT, so you cant eliminate the risk completely. But there are some steps you can take to reduce your risk of blood clots.
Keep moving. If you are overweight and sedentary, that will affect your blood flow and increase your risk for deep vein thrombosis in pregnancy, Dr. Berens says. So stay active and maintain a healthy weight. If you have to be on bed rest because of an injury or complication in your pregnancy, your doctor may prescribe blood thinners as a precautionary measure.
Get up during travel. Flying in itself is a risk factor for DVT, so pregnant women who fly are definitely at an increased risk, Berens said. If you have to fly, get up and move around every hour or two and do ankle roll exercises while you sit. And do the same thing if you go on a long car or bus ride, she added.
Wear compression stockings. Because they help improve circulation and reduce swelling in the legs, compression stockings can help lower your risk of deep vein thrombosis in pregnancy, Roshan said.
Drink lots of water. Staying hydrated during pregnancy helps prevent clots by keeping the blood from getting too thick, Roshan said. The CDC recommends that women drink 10 glasses of liquid every day during pregnancy and 12 to 13 glasses every day while breastfeeding.
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Anticoagulation During Pregnancy: Evolving Strategies
- Alshawabkeh L, Economy KE, Valente AM.
- Anticoagulation During Pregnancy: Evolving Strategies With a Focus on Mechanical Valves. J Am Coll Cardiol 2016 68:1804-1813.
The following are nine key points to remember from this review article on the use of anticoagulant medications during pregnancy:
Is Lovenox Safe For Pregnant People To Take
If you have recently been prescribed Lovenox to manage a blood clot during pregnancy, or are at risk of experiencing a blood clot during pregnancy, you might be wondering if Lovenox is safe to take. Your concern is understandable: any time you take medication while pregnant, you need to make sure that its safe for yourself and for your growing baby.
Dr. Langdon offers some general advice about Lovenox. While at this time, there unfortunately isnt much evidence about the safety of Lovenox during pregnancy, she says that for the most part, there are not adverse fetal or pregnancy effects.
Dr. Langon believes that as an anticoagulant , Lovenox is a better option than aspirin. She also recommends Lovenox over Herapin, another common anticoagulant sometimes given to pregnant people to prevent blood clots.
Heparin used to be the gold standard, but more and more people are using Lovenox and the international consensus is that it should be first-line therapy due to less frequent dosing, higher bioavailability, longer half-life, more predictable response, and less laboratory testing, explains Dr. Langdon.
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How To Store Naproxen
The drug is best stored at room temperature, keep away from direct light and damp places. Do not store in the bathroom. Dont freeze. Other manufacturers of this medication might have different storage principles.
Pay attention to the storage instructions on the product packaging or check with your pharmacist. Keep all medications out of reach of kids and pets.
Do not flush the medicines into the toilet or the sewer unless instructed.
Dispose of the product once the validity interval has expired or if its no more desired.Consult a pharmacist or local waste disposal company on how to safely dispose of your product.
Is It Safe To Breast Feed When On Blood Thinning
The blood thinning medication are not found in breast milk and so breast feeding is safe whilst on blood thinning.
Resources used to produce this information sheet.
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Other Medicines And Remedies
If you’re taking anticoagulants, you should speak to your GP, anticoagulant clinic or pharmacist before taking any other medicine, remedy or supplement.
This includes prescription medicines, medicines bought over the counter without a prescription , and any herbal remedies .
Some treatments can stop anticoagulants working or can increase the effect they have, which can be dangerous.
Some of the medicines that can affect anticoagulants include certain:
For a full list of medicines that you should avoid, check the patient information leaflet that comes with your medicine.
Prevent Falls And Injuries
If you have a high risk of falling, make these changes in your life to prevent falls:
- Wear slippers or shoes that have non-skid soles.
- Use a cane or walker if you need one.
- Put things within easy reach so that you don’t need to reach over your head for them.
- Keep a cordless phone and a flashlight with new batteries by your bed.
Make these changes in your home to prevent falls:
- Remove raised doorway thresholds, throw rugs, and clutter.
- Rearrange furniture and electrical cords to keep them out of walking paths.
- Keep stairways, porches, and outside walkways well lit. Use night-lights in hallways and bathrooms.
- Install sturdy handrails on stairways. Install grab handles and non-skid mats inside and outside your shower or tub and near the toilet.
- Add extra light switches if needed or use remote switches, such as sound-activated switches, on lights by doors and near your bed. Then you won’t have to get up quickly to turn on the light or walk across the room in the dark.
- Repair loose carpet or raised areas in the floor that may cause you to trip.
- Use shower chairs and bath benches.
- Use non-skid floor wax. Wipe up spills right away, especially on ceramic tile floors.
- If you live in an area that gets snow and ice in the winter, have a family member or friend sprinkle salt or sand on slippery steps and sidewalks.
To prevent injuries, be careful with your activities:
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Do You Have A History Of Blood Clots Or An Inherited Or Acquired Blood Clotting Disorder
Theres more information you may need:
Anticoagulation Therapy While Pregnant
While oral anticoagulants, or blood thinners, such as warfarin, dabigatran, rivaroxaban and apixaban are most commonly prescribed, they are not considered safe for unborn babies. Women who take blood thinners should contact their doctor immediately upon finding out they are pregnant. Your doctor may recommend that you switch from blood thinning pills to blood thinning medications that are injected under the skin, such as standard or unfractionated heparin and also low-molecular-weight heparin , because they do not cross the placenta or enter the bloodstream of the unborn baby and are safe to use during pregnancy. LMWH is preferred over heparin because it presents fewer side effects. Women can rest assured that injections are not dangerous to the fetus, even though they are given in the abdomen, because the needles are very small and do not reach beyond the fatty layers of stomach tissue just beneath the skin. Heparin and LMWH have been used in pregnancy by thousands of women with no birth defects or bleeding problems in their unborn babies.
Giving Birth While Taking Blood Thinners
Risk Management After Giving Birth
Women are at their highest risk of a blood clot in the six weeks following the babys birth.
Women can breastfeed while on LMWH injections or warfarin, but the safety of newer oral anticoagulants as it pertains to breastfeeding has not yet been determined.
Know The Signs Of Bleeding
911 or other emergency services right away if:
- You have a sudden, severe headache that is different from past headaches.
or seek immediate medical care if you have any abnormal bleeding, such as:
- You cough up blood.
- You vomit blood or what looks like coffee grounds.
- Your stools are black and look like tar or have streaks of blood.
- You have a nosebleed that doesn’t stop quickly.
- You have blood in your urine.
- Vaginal bleeding that is different than what you are used to.
- You have new bruises or blood spots under your skin without a known cause.
If you are injured, apply pressure to stop bleeding. Realize that it will take longer than you are used to for the bleeding to stop. If you can’t get the bleeding to stop, call your doctor.
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What Can I Do To Reduce My Risk Of Blood Clots
- Know the signs and symptoms of a blood clot. On an affected limb like a leg or arm, you may notice swelling, pain or tenderness that was not caused by an injury, warm skin when you touch it or redness and discoloration. Contact your provider if you experience any of these symptoms.
- Talk to your provider about your risk. If you or a family member like a parent, brother or sister have had blood clots before, tell your provider.
- Move or stretch on long trips. If you sit for more than 4 hours on a trip, try to move your legs often. If you can walk around, you may do so. If you cant, you may try seated leg stretches like extending your legs straight out and moving your ankles to move your toes toward and away from you. You may also pull your knee to your chest and hold it there with your hands for 15 seconds.
- Follow other travel tips for reducing risk of blood clots. These include drinking lots of fluids like water, wearing loose-fitted clothing or wearing special stockings that compress your legs below the knee. Talk to your provider before trying these stockings.
- Follow your providers instructions during pregnancy and after giving birth. Your provider may give you medications like blood thinners or ask you to come in for additional prenatal care checkups.